It was about the staff, and to a lesser extent the patients, in the rundown Boston teaching hospital St. Eligius (nicknamed "St. Elsewhere"). The show was Soap Operatic at times with frequent doses of Black Comedy, and had numerous Very Special Episodes. It ran for six seasons, appeared to have strong continuity for the most part, was written well enough for the most part that people got attached to the characters, had crossed over with numerous other network properties (most notably sister series Homicide Life On The Street), and it was both popular and critically acclaimed while it was running. It was truly Must-See TV.

...Well, until the controversialGrand Finale. At the end, as the camera zoomed out to show snow falling on St. Eligius, America discovered the horrible truth about the events they had witnessed over the past six years. This final scene continues to enjoy debate to this day, thanks mostly to the proliferation of crossovers both Elsewhere and Homicide enjoyed.

As a result, St. Elsewhere is now remembered as the definitive All Just a Dream series, although it can also be seen as breaking the fourth wall (with the snow globe containing the hospital representing the television set containing all the fictional events, as a metaphorical way to finish the story).

This show contains examples of:

Accidental Public Confession: a Type 3 example, when Roberta tells the page nurse about her marital problems with Victor, not realizing she had just turned the hospital's PA mic on while looking for a pencil.

Anyone Can Die: Not even Santa Claus and Mimsie, MTM Enterprises' adorable kitten mascot, are safe.

Ascended Extra: Dr. Jackie Wade (Sagan Lewis) goes from a character with one line in the pilot to recurring character in the same season before getting promoted to the opening titles in Season 6.

Lucy Papandrao (Jennifer Savidge) has a similar arc: she's an uncredited nurse in the pilot's OR scene who appears as a recurring character the same season, with more prominent appearances in the following years

Bar Brawl: in the episode "Remembrance of Things Past" between Chandler, Fiscus, Caldwell, Erlich, and some rude drunks. Includes a Bar Slide.

Billing Displacement: Denzel Washington is front and center on the DVD box, despite being a supporting player.

Break the Cutie: Poor Cathy Martin. After being raped twice and beaten by Peter White, she is irrevocably broken.

Break the Haughty: Dr. Craig. His son dies, his artificial heart patient regrets his surgery and then dies, he punches a mirror and injures his hand, leaving him unable to operate, and his wife leaves him and begins an affair with another man. They eventually reconcile. Oh, and in one episode, he's mistaken for being homeless.

Brick Joke: Throughout Season 5, Dr. Auschlander makes reference to a news, sport, or cultural event in his conversations with other doctors, with the references going back three years each subsequent episode. By the end of the season, the references are close to the time Auschlander was born. Not coincidentally, his mental state has also degraded to the point where he is like a helpless child.

This was done so subtly in the scripts, Norman Lloyd didn't even catch on until the producers told him.

Let's see, his wife dies tragically, his toddler son disappears (but eventually is found), he gets raped during a prison riot by the husband of a former patient in an especially brutal Call Back to Season 1, and then later said rapist escapes prison, stalks Boomer, and finally takes him and his new wife and kids hostage, only to be saved when Boomer's son, who's around six by now, shoots the rapist dead.

Bus Crash: Bobby Caldwell's (off-screen) death from AIDS in season six's "Heaven's Skate".

Call Back: Early in Season 1, a sociopathic domestic terrorist detonates a bomb in a bank, killing and wounding many, including the bomber. The causalities are brought to St. Eligius, including the bomber. The husband of one of the victims comes to the hospital, and after his wife dies ends up wandering around aimlessly throughout the episode. Finally, when the time comes to transfer the bomber to the US Marshals, the distraught husband appears out of nowhere and shoots the bomber dead. Roll credits. Now, flash forward several seasons. Boomer Morrison is volunteering at a prison clinic, where he ends up treating the husband who's been serving hard time for murdering the bomber. Somehow during the episode, a prison riot breaks out, Boomer ends up being taken hostage by the husband who then proceeds to make with the prison rape. It's stuff like this that makes the show memorable for its continuity.

Celebrity Paradox: Sort of. In the Season 2 episode "Hello and Goodbye", Morrison takes his son to "the bar that inspired Cheers", but then in the Season 3 episode "Cheers", Dr. Craig and Dr. Westphall visit the bar from Cheers where they interact with the characters from the show!

Character Development: Many characters went through this as the show went on, most notably Victor Ehrlich (who matures enough to marry nurse Lucy Papandrao in the last season) and Luther Hawkins (who becomes a protege of sorts to Dr. Auschlander, and ends up becoming a physicians' assistant by series end).

Demoted to Extra: Joan Halloran (Nancy Stafford), an administrator brought in by the City of Boston to improve efficiency at the hospital, goes from a regular character in the opening credits in season 2 and having major clashes with Drs. Westphall, Auschlander, and Craig, as well as having a romance arc with Bobby Caldwell, to a recurring character in season 3. Halloran's screen time would continue to be reduced until she ultimately got Put on a Bus after Stafford left to play Michelle Thomas on Matlock.

Funny Background Event: When Westphall leaves the hospital temporarily in the season 4 premiere, a frazzled Lucy Papandrao tells one of the characters she feels like screaming. When the character has a conversation with another doctor, Lucy is seen behind them in the nurse's lounge, screaming.

Furry Fandom: The Birdman of St. Elsewhere is probably the Ur Example in mainstream media. Ironically, he's written with considerably more nuance and sensitivity than most people who think they're animals are written on TV today, now that furry fandom is more widely known and heavily associated with squickiness. The show still used him mostly for laughs, although it avoided making viewers look down their nose at him; so when the Birdman decides he can fly away from the hospital by jumping off the roof...nobody's laughing.

Gainax Ending: One of the most famous examples; the whole show was just the imagination of an autistic kid. What.

Heroic Sacrifice: While he's being treated for a massive heart attack that almost killed him, Dr. Elliot Axelrod's room-mate goes into a Code Blue situation. Elliot, despite being on his last legs, gets out of bed to help as he's technically the closest doctor around. The strain and the stress of cause Axelrod to have another heart attack, but even while dying himself he gets the patient's heart restarted.

He Who Must Not Be Seen: Dr. Oliver London (Craig's main surgical rival at St. Eligius) and Robert Wade (Dr. Wade's husband).

Main characters who were Killed Off for Real include Dr. White (shot by Shirley Daniels), Nina Morrison's sudden death due to a freak slip-and-fall head injury, Wendy Armstrong's suicide, Mrs. Huffnagel getting eaten by her hospital bed, Elliot Axelrod's heart attack., and Dr. Auschlander's death in the finale.

Maybe Magic, Maybe Mundane: Dr. Fiscus' unconscious young patient is accompanied by a middle-aged woman claiming to be his fairy godmother; a miraculous improvement in the boy's condition and the random appearance and disappearance of the woman have Fiscus wondering.

No Good Deed Goes Unpunished: Dr. Westphall sets up a community outreach program, to have the residents perform community service. Dr. Ehrlich goes to work with inner city youths and gets mugged. Dr Chandler goes to work at a women's health clinic, which is bombed by protesters. The next day, a second bomb goes off at St. Eligius, injuring only him, then goes to work for a suicide hotline a girl calls several times wanting to kill herself. The next morning, she calls back and it seems like she's doing better, then Chandler hears a gunshot. Dr. Morrison goes to work at a prison clinic, and is raped by an inmate.

Phrase Catcher: Especially throughout Season 2. "You're a pig, Ehrlich."

Previously On / On the Next: Just about every episode of the first five seasons began with a summary of previous events that were pertinent to the episode, and some added a little snippet of events from that night's episode. In the final season, they switched to a cold open before the credits.

Revenge: Shirley Daniels shoots Dr. White to avenge the rape of Cathy Martin. If you watch the scene carefully, you'll see that she actually shoots him twice...and, appropriately, the first shot isn't to the heart.

Running Gag: Season 2 has every major character call Dr. Ehrlich a pig.

Sanity Slippage: The residency program, coupled with marital problems, eventually became too much for Dr. White.

Series Continuity Error: In a Season 2 episode, Dr. Westphall tells a family that he doesn't believe in taking comatose patients off of life support, and yet in the Season 4 Whole Episode Flashback "Time Heals", he is shown personally disconnecting his brain-dead wife from life support, which happened several years before the events of the Season 2 episode!

Byron Stewart plays Warren Coolidge, an orderly. It turns out this is the same character he played on The White Shadow. When Timothy Van Patten guest stars on the episode "Any Portrait in a Storm," they run into each other. Stewart says "Hey Salami!" but Van Patten tells him he must be confusing him with someone else.

Before Victor's wedding, as he's having second thoughts due to a mysterious other woman, Dr. Craig tells him, "This is not 1968. It's time you graduate into adulthood. Don't drive over troubled waters with some plastic bimbette " A shout out to The Graduate (William Daniels played Dustin Hoffman's father in the movie), its theme song singers Simon & Garfunkel, and the famous one word of investment advice.

When Ellen Craig suggests she goes into grief counseling after a few events re-trigger her pain following her son's death, Mark Craig dismissively tells her "Simon's Broadway bound". Philip Sterling, the actor who played psychiatrist Dr. Simon Weiss, was appearing on stage in Broadway Bound at the time.

Surprise Pregnancy: Happened to an obese woman in "Hearts", and to a severely developmentally-disabled women after she and a similarly-disabled young man get it on. It's kind of hard to believe this show was on network TV.

Talking in Your Dreams: In the episode "Sweet Dreams," Morrison has a nightmare where Peter White talks with him from beyond the grave, and creepily confesses that he deserved to be killed.

The Troubles: In the Season 2 episode "Under Pressure", two Irish boys (one Catholic, one Protestant) end up in the ER after fighting. One boy's mother references The Troubles by name.

Uncle Tomfoolery: Luther, in earlier seasons; Dr. Chandler even called him out on it. Luther eventually got better in later seasons, first becoming a paramedic and then studying to become a physician's assistant.

Whole Episode Flashback: The Season 4 two-parter "Time Heals", in which we see St. Eligius in its early days, Dr. Auschlander as a young doctor, and Dr. Westphall as an angry young juvenile delinquent. Also features Dr. Craig as an arrogant, sycophantic resident and Helen Rosenthal as a young newlywed.

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